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Reasonable adjustments request

Reasonable adjustments request

Reasonable adjustments

Do you have an impairment with substantial and long-term adverse effect on normal day to day activity?
This means you have a disability or health condition that makes it hard for you to do everyday things for a long time. For example, it could be difficult to walk, see, hear, or remember things.
Do you have a reasonable adjustment for health and care access?
This means you need changes or extra help to access healthcare services. For example, you might need information in large print, extra time for appointments, or help to move around the clinic.

Consent to share

We also want to ask if it’s okay to share our adjustments with other teams in the NHS or social care. This will help them know what changes (Reasonable Adjustments) you might need when you see them.

Do you consent to share your reasonable adjustment?

Your privacy is important to us. All information provided will be handled in accordance with our privacy policy and relevant data protection laws. If you have any questions or need assistance with this form, please contact our practice. Thank you for helping us make our healthcare services more accessible to everyone.